Radiation diagnostics of respiratory disorder syndrome in newborns

ЯНГИ ТУ Ғ ИЛГАН ЧА Қ АЛО Қ ЛАРДА НАФАС БУЗИЛИШИ СИНДРОМИНИНГ НУР ДИАГНОСТИКАСИ

Зотилжам таш ҳ исли ча қ ало қ ларда гестация муддатига бо ғ ли қ ҳ олда етуклик белгисини рентгенологик белгилари комплекс ўрганилди ва нафас бузилиш синдроми белгилари билан ту ғ илган болаларни диагностик белгилари кузатув давомида ани қ ланди. Ча қ ало қ ларда ўпка тў қ имасини етилмаганлиги фонида ялли ғ ланиш жараёнига бо ғ ли қ рентгенологик ўзгаришлар верификацияси вариантлари ажратилган. Янги ту ғ илган ча қ ало қ ларда пневмония рентгенологик тад қ и қ отлар натижалари неонатал даврда ўтказиш кераклиги, ўпкада қ айтарилмас ўзгаришлар, сурункали нафас олиш етишмовчилигининг, катта ёшдаги болаларда бронхо-обструктив синдром ва бронхопульмонал дисплазия ривожланишига тўс қ инлик қ иладиган даволаш тактикасини ишлаб чи қ ишга ёрдам беради..

Калит сўзлар : рентгенография, янги ту ғ илган ча қ ало қ лар, муддатдан олдин ту ғ илган ча қ ало қ лар, нафас бузилиш синдроми, пневмония.

Pneumonia is a fairly common form of respiratory damage in children in all age groups. Respiratory diseases are widespread among the child population and have a large share in the morbidity structure, especially in newborns.

An alarming trend in modern neonatology is the almost universal increase in the birth rate of children with respiratory disorders, the most common causes of which are SDR and pneumonia of newborns. It should be noted that in recent years, respiratory disorders of newborns have attracted great attention of researchers, because often their outcome is chronic respiratory failure, broncho-obstructive syndrome, bronchopulmonary dysplasia in older children.In recent years, respiratory disorders in newborns have attracted a lot of attention from researchers because often their outcome is chronic respiratory failure, broncho-obstructive syndrome, bronchopulmonary dysplasia in older children [1,3,4]. The timeliness of assessing the state of the respiratory system in newborns and especially premature infants, as well as the presence of signs of morphological immaturity in the syndrome of respiratory disorders (RDS), requires widespread use of well-known examination methods, in particular, it concerns timely X-ray examination. X-ray examination of newborns with modern advanced X-ray technology remains the leading and most accessible method for diagnosing respiratory diseases in newborns [2].

The aim of the study was to determine the radiological criteria for the severity of SDR in pneumonia of the newborn.

Materials and research methods. Clinical and X-ray examination of 100 newborns was carried out, including 50 full-term newborns and 50 premature newborns with prematurity of I and II degrees. X-ray examination was carried out on a KX050F - "Toshiba" apparatus, made in Japan. During chest x-ray in children, the following technical conditions were adhered to: voltage of 50-55 kV, current of 100-150 mA, holding time 0.03-0.04 seconds.

Results and discussion. Newborn children born with RDS require special attention from the first days of illness and professionally competent medical tactics. Clarification by the radiologist of the severity of the RDS of the newborn with pneumonia allows the most accurate and objective assessment of the severity of the sick child. X-ray examination of premature infants with pneumonia showed the prevalence of manifestations of signs characteristic of RDS. In all observations in the groups of premature infants, a decrease in pneumatization of the pulmonary fields was characterized by varying degrees of severity, including darkening like ground glass and "white lungs". In full-term, a moderate decrease in airiness was noted only in 20% of cases.

On radiographs, in addition to signs of impaired ventilation, shadows from miliary spotting of the reticulogranular pattern with a gradual general uniform veiling to large or conglomerate lobular shadows and general diffuse hypopneumatosis or apnematosis of all lobes were observed. Areas of darkening in the lungs of premature infants were expressed by bilateral diffuse mesh-focal infiltration and compensatory multifocal emphysema. In fullterm newborns, along with diffuse focal changes, grouping of focal shadows was most often observed, manifested by areas of limited darkening of the mosaic structure (due to air and swollen groups of lobules that are not involved in the inflammatory process) with their predominant localization in individual segments, which are somewhat delayed in its development.

Shadows of various intensities were simultaneously visualized on the X-ray diffraction patterns, which indicates their occurrence at different times and unequal depth of occurrence. Diffusely widespread multiple small focal blackouts very often tended to merge and were combined with multifocal swellings. In the group of patients with prematurity up to 60% of cases, along with low-intensity focal shadows, small-focal shadows of somewhat high density were visualized, very characteristic of atelectasized lobules, which proved the development of pneumonia against the background of pneumopathy.

The symptom of increased vascular pattern, characteristic of the inflammatory process, did not manifest itself in the groups of premature babies we examined. Analysis of the X-ray picture of the pulmonary pattern revealed that a certain number of premature infants, due to their immaturity, were characterized by a depletion of the vascular pattern (36%). There was an enrichment of the nodose-reticular mesh type, caused by widened interlobular septa and manifested by gentle polygonal shadows of varying length and detected in most cases (60%). The symptom of "air bronchogram" was also more often detected in the group of immature newborns. Assessing the condition of the roots of the lungs, sometimes (20%) it was not possible to identify their pattern due to the increased shadow of the mediastinal organs, as well as because of the additional shadow in the root zone due to the involvement of interstitial tissue in the process, which was interpreted as an expansion of the root zone (72%).

When X-ray analysis of combinations of various forms of pulmonological pathology, it is necessary to bear in mind that each component, interacting with others, changes its pathological and pathophysiological appearance, which ultimately contributes to the formation of the corresponding severity of X-ray signs of RDS in newborns, depending on the signs of immaturity.

Based on our own observations and analyzing the available information in the literature, as well as generalizing the classifications we studied about the X-ray manifestations of the RDS stages, we identified the following version of the X-ray verification of changes in degrees depending on the severity of the X-ray manifestations and the severity of signs that occur during the inflammatory process against the background of immaturity of the lung tissue. I degree of severity: moderate decrease in pneumatization, miliary spotting, limited low-intensity shadows, nodose-reticular mesh (vague), "air bronchogram" is distinguishable. II degree of severity: decreased pneumatization, rough, randomly scattered areas of the seals of the lung tissue, nodose-reticular mesh, "air bronchograms". III degree of severity: a pronounced decrease in pneumatization